Medical Services in New Zealand and The Pacific
III: Prisoner-of-war Hospitals
III: Prisoner-of-war Hospitals
It was the policy of the Germans to provide in prisoner-of-war hospitals a skeleton administrative staff only, with usually one page 135 German medical officer acting as medical superintendent. Thus, all the medical and surgical work and nursing was done by Medical Corps personnel and others from among the prisoners themselves. Only very rarely were prisoners of war treated in German civilian or military hospitals; those who were so treated generally spoke well of the care, attention and food.
British medical officers and orderlies were sent to hospitals indiscriminately by the Germans. Other medical men, as they arrived in Germany, were fortunate enough to be employed at such Lazaretts as Lamsdorf, Cosel, Tost, Königswartha, Schultherg, Obermasfeld, Kloster Haina, Marlag-Milag Nord, Berlin, etc. If they lacked a specialised knowledge of a particular disease they had to learn about it from books, if available, or from German and French doctors. This was so at Elsterhorst, but an efficient team was built up largely in spite of, and rarely with the real assistance and co-operation of, German officialdom.
German arrangements for the transport of tuberculous prisoners of war, and indeed of all sick prisoners, were casual and haphazard in the extreme. It was common for patients to spend days in trains, usually standing, with most making several transfers, during which they carried their own baggage. Right up to the last, the four miles between Elsterhorst station and the tuberculosis hospital was often completed on foot by patients.
Side by side with the work of the British teams of medical officers and orderlies went the invaluable contributions of the Red Cross. The food parcels sent by that organisation were directly responsible for the survival of very many prisoners of war, let alone those who were sick. The invalid comforts section, with its extras, its occupational therapy parcels, and its instruments and drugs, contributed much, enabling patients to live who would otherwise have died. No tribute to the Red Cross can be too effusive, for all prisoners of war owe much, and many their very lives, to its magnificent work.
It can be said that the German medical organisation for the care of prisoners of war was not fully adequate, nor was the transport of sick, particularly of pulmonary tuberculosis cases. Medically, far too much was left to the initiative of the prisoners themselves. In general, it can be said that their rights under the Geneva Convention were constantly demanded by the British, but frequently they were accorded them by the Germans as privileges.
There was always considerable difficulty in getting sufficient medical orderlies to staff the hospitals adequately. Although it was known, for instance, that there were hundreds of British orderlies at Stalag VIIIB, Lamsdorf, of whom the majority were not employed as medical orderlies, it seemed impossible to get them transferred to page 136 hospitals where their services were urgently required. The German establishment provided for only about five or six medical orderlies to each hundred patients. However, the British medical officers usually managed to increase this allowance. Thus at Elsterhorst, a 500-bed hospital, Lieutenant-Colonel Bull had some sixty medical orderlies.
The British medical officers in captivity had an unending struggle with the Germans. In general, they had to fight for everything they got in the way of medical supplies and facilities for those in their medical care. The German medical officers were found to fall into one of two general categories – an older group who had qualified in pre-Nazi days, and a younger group who qualified during the Hitler regime. There was a vast difference between the two types. The older group could often be professionally respected by the British medical officers, were helpful, realised the difficulties and often had a sense of humour. The younger group, on the other hand, were usually arrogant, clinically unsound, and did not hesitate to say that the British medical officers presented cases to the Mixed Medical Commission on political rather than clinical grounds just to get their compatriots repatriated. The Germans, as was perhaps natural, did not put their best doctors in charge of prisoners of war. Against this background the achievements of the British medical officers are enhanced.
There were four types of prisoner-of-war hospitals in Germany: the general hospitals, the special hospitals, the mixed general hospitals, the prisoner-of-war wards in German hospitals.
The General Hospitals
The Lazarett at Lamsdorf was run on the lines of any other German hospital, with a German area Chefarzt,1 having the rank of Oberstabsarzt,2 but with a British staff of specialists and assistants under him – some fourteen British medical staff in all, including 3 surgeons, 1 assistant surgeon, 3 physicians, 3 psychiatrists, 2 anaesthetists, 1 radiologist and 1 padre. The chief dispenser was a German.
Lazarett Lamsdorf: This hospital, opened on 13 October 1941, was planned to serve the needs of over 30,000 men and was undoubtedly the best designed and equipped hospital for British prisoners of war in Germany. It occupied six acres of flat land in page 137 a forest and its eleven concrete buildings were fitted with double windows and wooden shutters. In every room was a large, efficient tiled stove. Six buildings were self-contained parallel blocks of wards, each holding from seventy to one hundred patients. The five service buildings were the staff, administrative and treatment blocks, kitchen and morgue. In the area was a large brick Red Cross as a sign for aircraft.
The ward blocks were divided up into large and small wards, with service rooms as in a modern hospital with the necessary sanitary conveniences. The operating theatres were well equipped with efficient sterilising and full X-ray and laboratory facilities. Although the overall control was in the hands of a German medical officer, full control of the clinical work was eventually given to the British medical officers working under a senior British officer. The nursing orderlies were all British and lived at the hospital, while a daily party of general duty men was drawn from Stalag VIIIB. There was a German chief dispenser in control of the stores, but otherwise the staff of the service departments was British. Besides physicians and surgeons there were British anaesthetic, ophthalmic, radiological, neurosurgical, psychiatric and ENT specialists available either on the regular staff or visiting the hospital from time to time.
When Lazarett Lamsdorf opened the staff largely consisted of British Expeditionary Force medical orderlies. A few early arrivals in Germany from Greece, New Zealanders and others, were also chosen for the staff. These men were particularly keen; and, encouraged by their medical officers, who gave them regular courses in nursing, anatomy, physiology, etc., they rapidly achieved a remarkably high standard of nursing. The ‘ward charges’ were fully qualified state registered male nurses, who ran their wards with precision be they medical, surgical, infectious or mental. The office staff, too, trained in the BEF general hospital, had no difficulty in coping immediately with the German hospital methods. The special departments also, i.e., X-ray, theatre, dispensary, laboratory, massage, pack store, kitchens, were all run with a high and pleasing standard of efficiency. The quarters given to orderlies there were better than they had ever dreamed of in their philosophies as prisoners of war, and none wished to return to the squalor of the main stalag. There was, therefore, an incentive to work well.
A mixed medical commission visited the hospital twice yearly to inspect and also to determine which patients should be repatriated. Full case records were kept, with copies available for the Germans and the original for the United Kingdom, German forms being used. Admissions from the camp were arranged from a waiting list drawn up by the senior physician and surgeon at clinics in the camp, page 138 and urgent cases were admitted at any time. Special accommodation was provided for the infectious and mental cases. The rations supplied by the Germans were meagre, but the Red Cross parcels enabled a satisfactory diet to be maintained and four meals a day were served in the wards.
Entertainment and sport were permitted freely. In general, the Germans appear to have provided an excellent hospital, with all supplies satisfactory except the rations, and to have allowed the British medical personnel to carry out their work with a minimum of control.
Captured with the British prisoners were several specialists of note who were employed in their own specialities. Major Henderson, RAMC, a neurosurgeon, was resident for four months on two occasions at Lazarett Lamsdorf doing nerve suture work. Major Cuffy, Rome, visited Lazarett Lamsdorf in 1942 and 1943 from Obermas-feld to do ear-nose-throat surgery, and Major Wright-Thomson was in charge of the ophthalmic services for Stalag VIIIB.
Their services were invaluable to captors and captives alike.
Dental Treatment: Fortunately for the prisoners of war there were dentists among their number in captivity, and many hospitals had a dentist attached. In captivity there was considerable deterioration of teeth due probably to, first, lack of regular maintenance work, and, second, to a high carbohydrate diet. The volume of work offering was beyond the capacity of the few dentists available. From the point of view of the prisoners it was a blessing that the New Zealand Mobile Dental Unit was captured in Greece, as its officers did magnificent work throughout the length and breadth of Germany, and their training and efficiency was found to be of a much higher standard than that of dentists of other nationalities.
The Special Hospitals
In 1942, at Kloster Haina, the Germans opened a ‘centre for the blind’ to which all with eye injuries were sent. Major D. Charters, RAMC, eye specialist of 26 General Hospital, was OC and instrumental in founding this centre. The blind were taught braille, and in many respects received excellent rehabilitation.
At Königswartha all cases of pulmonary tuberculosis were collected. Conditions were far from satisfactory at first, as accommodation was very poor, equipment was limited and there was a shortage of staff, despite the transfer of British medical officers and orderlies to the hospital in 1942. After the arrival of Lieutenant-Colonel L. E. Le Soeuf, AAMC, in August 1942 administration, organisation and treatment all improved, but Colonel Le Soeuf petitioned for better conditions with the result that in March 1943 page 139 the patients were transferred to Elsterhorst, where a general hospital for prisoners of war had been specially built. At Elsterhorst facilities for surgery were much better and by then special thoracic instruments had been obtained. Later in the year serial radiography was begun among prisoner-of-war working parties to detect cases of tuberculosis. After being passed by the Mixed Medical Commission groups of patients were repatriated in October 1943, May and September 1944 and January 1945. Lieutenant-Colonel Le Soeuf was transferred elsewhere in May 1944 and his place as SBMO was taken by Lieutenant-Colonel Bull, NZMC. Over 1000 British patients, most of them from the United Kingdom, passed through the tuberculosis hospitals. There were only twenty-two New Zealanders admitted and two died; but twenty more cases were first diagnosed after repatriation to England in April 1945.
The Mixed Hospitals
These were hospitals established to deal with prisoners of war in general and not with ‘British prisoners’ alone.
One of the first to function was Teil-Lazarett, Cosel, which housed in most primitive conditions Russian, Serbian and a few British sick in the Cosel district. In 1942, because of overtures from British medical officers nearby, and because of adverse reports carried to the central stalag by visiting British padres, British medical officers were detailed by the Germans to go to Cosel to assist the Serbian doctors. Shortly after, following an outbreak of severe summer diarrhoea due to hopeless sanitary arrangements, the benign and ineffective German Chefarzt was replaced by an active German organiser; and, with plenty of effort from the British as well, the hospital soon became a reasonably satisfactory institution.
It catered for 100 British, 200 French, 300 Russians and some Serbians. On its staff were British surgeons and physicians, a French physician, a Serbian surgeon and a British administrative OC, and two New Zealand medical officers (Captains Stevenson-Wright and Foreman).
From July 1942 to November 1943 Stevenson-Wright and Foreman worked in the hospital at Cosel. The hospital then housed 300 Russian and 100 French and British sick prisoners of war. At first, housing conditions were little better than those in Stalag VIIIE, the notorious camp for Russians at Neuhammer, although the feeding was better. Among the Russians all types of medical diseases were seen, the most common being all forms of tuberculosis, famine oedema and dysentery. All manifestations of vitamin deficiency were frequently seen but in nearly two years only four cases of beri-beri were admitted. These four cases were in men apparently page 140 well nourished who worked in a sugar-beet factory. Here again the state of the Russian prisoners admitted to the hospital showed the inhuman way they were being treated by the Germans, who made them work hard on construction work and gave them totally inadequate food. In 1945 the Cosel hospital was transformed into a pleasant, efficient hospital, thanks to the Senior British Medical Officer and the Red Cross and a co-operative German doctor. It was interesting for the New Zealand medical officers, following this period in Cosel hospital, to return to work again at the British stalag at Lamsdorf, where among better nourished and cared-for prisoners of war the only illnesses seen were those encountered in a small town anywhere with a population of 10,000.
A similar mixed 600-bed hospital was commenced at Tost in May 1944, functioning until the area was liberated by the Russians in January 1945. It was under command of Major S. G. de Clive Lowe, NZMC. Those taken by the Russians were finally released through Odessa, going through the Mediterranean Sea to Egypt and England.
Prisoner-of-war Wards in German Hospitals
In areas where there were no British prisoner-of-war hospitals it became the custom to admit and treat British prisoners in German hospitals. In smaller hospitals very frequently the British were treated in the same wards as the Germans. In the larger hospitals, or stricter hospitals, the prisoner of war was segregated and treated in his own barracks, as, for example, in Reserve Lazarett IX in Breslau, where neuro-surgery and orthopaedics were concentrated; or in Kattowitz, where oto-rhino-laryngology was the speciality. One point is interesting. Although the Germans did not withhold their own hospital rations from the prisoners of war, even issuing a chocolate ration to them, they did not like the British opening and demonstrating their British Red Cross food parcels before the wounded German soldiers' eyes.
In all hospitals the German medical Chefarzt usually made a weekly round of the wards.
1 Medical Superintendent.